Public Forum To Address Safety Issues On Vaccines

By GARDINER HARRIS

Published: April 11, 2008

In the midst of yet another controversy about whether vaccines cause autism, the federal government will hold its first ever public meeting on Friday to discuss a governmentwide research agenda to explore the safety of vaccines.

The meeting is intended to help defuse years of criticism from vaccine skeptics that the government is hiding what it knows about vaccine safety or failing to investigate the issue diligently.

But the gathering is unlikely to appease the government's many critics in part because the latest notion to grip vaccine skeptics -- that vaccinations trigger or worsen something called mitochondrial dysfunction, which in turn causes autism -- will remain largely unaddressed.

''I think there could be real frustration,'' Dr. Bruce Gellin, director of the National Vaccine Program Office, which is coordinating the meeting, said in an interview Thursday.

Indeed, Margaret Dunkle, senior fellow at the Center for Health Services Research and Policy at George Washington University, said government experts needed to take into account the latest controversy.

''If they just talk about the same old issues and don't reflect what we now know and the concession the government has made, that would be a huge disappointment,'' Ms. Dunkle said.

Ms. Dunkle's niece, Hannah Poling, of Athens, Ga., was 19 months old and developing normally in 2000 when she received five shots against nine infectious diseases. She became sick and later developed autism.

Her parents sued, and late last year government lawyers agreed to compensate the family on the theory that vaccines may have aggravated an underlying mitochondrial disorder. When news of the government settlement became public, vaccine skeptics said the government had finally conceded that vaccines cause autism.

Government officials and researchers said they had conceded no such thing.

''The Poling case has changed the media coverage of mitochondrial disorders but has added nothing to the discussions of what causes or doesn't cause autism,'' Dr. Edwin Trevathan, director of the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention, said in an interview Thursday.

On Friday, many of the main players involved in this debate -- including Hannah's mother and her grandparents, prominent vaccine skeptics and some of the government's top vaccine researchers -- will all be in the same room to discuss research priorities.

The meeting is the result of a 2005 report by the Institute of Medicine, which suggested that the disease control agency might engender more trust among skeptics if it included them in its research planning.

At the time, vaccine skeptics were lobbying to have greater access to the agency's Vaccine Safety Datalink system, a huge set of health records assembled by large managed care organizations. The agency uses the system to conduct epidemiological studies to measure whether vaccines or their components cause common problems.

Such studies, for instance, have found no link between the combined measles, mumps and rubella vaccine and autism, and they have found no link between a once-common vaccine additive, thimerosal, and autism.

In the face of such studies, vaccine skeptics have increasingly demanded clinical research, not epidemiological studies, to determine whether small groups of children may somehow be more susceptible to vaccine injuries than the general population. Such subsets of children might get lost in large epidemiological studies, they say.

But that kind of clinical research is generally undertaken or underwritten by the National Institutes of Health, not the disease control agency.

The issues raised by the Poling case ''can't go very far tomorrow because it's really not in C.D.C.'s lane,'' Dr. Gellin said.

No decisions are expected to come out of Friday's meeting; rather, it would allow researchers to hear the public's priorities.